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Tear Trough - Derma Filler
Marionette Line Filler - Restoring Lower - Face Balance and Softness
From £250 per session
Marionette lines are the downward creases that run from the corners of the mouth toward the chin, often giving a tired or downturned expression.
They develop as midface support diminishes and the depressor anguli oris (DAO) muscles pull the mouth corners down.
At Dr Hans Clinics, treatment focuses on re-supporting the area to restore harmony and neutral expression.
We use CE-certified hyaluronic acid (HA) fillers including Kysense®, Juvederm®, Belotero®, and Revanesse®, selected for appropriate lift capacity, softness, and reversibility.
All treatments are performed following a medical consultation and prescriber approval.
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HOW MARIONETTE FILLER WORKS
● With age, volume loss around the oral commissure and chin creates shadowing and downward folding.
● By restoring volume in the pre-jowl sulcus and perioral area, hyaluronic-acid filler provides lift and structural continuity between the cheek, mouth corner, and chin.
Mechanism:
● HA attracts water molecules, restoring dermal hydration and soft-tissue thickness.
● Subdermal and deep bolus placement along the marionette groove re-supports the oral commissure.
● Filler rheology (G′ and cohesivity) determines firmness and integration to maintain natural movement.
Onset: Immediate
Peak : 2 Months
Duration: typically 9 – 15 months
● By restoring volume in the pre-jowl sulcus and perioral area, hyaluronic-acid filler provides lift and structural continuity between the cheek, mouth corner, and chin.
Mechanism:
● HA attracts water molecules, restoring dermal hydration and soft-tissue thickness.
● Subdermal and deep bolus placement along the marionette groove re-supports the oral commissure.
● Filler rheology (G′ and cohesivity) determines firmness and integration to maintain natural movement.
Onset: Immediate
Peak : 2 Months
Duration: typically 9 – 15 months
WHY PATIENTS CHOOSE DR HANS CLINICS
● Doctor-led anatomical assessment to correct downward vectors without stiffness.
● Conservative dosing focused on proportional restoration.
● Use of micro-cannula to reduce bruising and vascular risk.
● CE-certified products only, with full documentation of batch and lot numbers.
● Conservative dosing focused on proportional restoration.
● Use of micro-cannula to reduce bruising and vascular risk.
● CE-certified products only, with full documentation of batch and lot numbers.
EVIDENCE & SAFETY
● Clinical studies confirm hyaluronic-acid fillers are effective for lower-face rejuvenation when performed by qualified medical practitioners (Aesth Surg J 2020; J Clin Aesthet Dermatol 2021).
● Temporary swelling or tenderness is expected for 24 – 48 hours.
● Rare complications include oedema, Tyndall effect (blueish hue), or vascular compromise – mitigated by appropriate product choice and anatomical precision.
● Serious complications such as vascular occlusion are exceedingly rare and mitigated by sterile technique, aspiration, and reversal protocols.
● Contra-indications: active skin infection, pregnancy, unhealed wounds, or recent dental work.
● Temporary swelling or tenderness is expected for 24 – 48 hours.
● Rare complications include oedema, Tyndall effect (blueish hue), or vascular compromise – mitigated by appropriate product choice and anatomical precision.
● Serious complications such as vascular occlusion are exceedingly rare and mitigated by sterile technique, aspiration, and reversal protocols.
● Contra-indications: active skin infection, pregnancy, unhealed wounds, or recent dental work.
TREATMENT PLAN & TECHNIQUE
● Consultation:Assessment of facial symmetry, vector analysis, and muscle pull.
● Technique:
● Anaesthesia: Topical or local if required.
● Procedure time: 30 – 45 minutes including consultation.
● Follow-up : 2 weeks to assess integration and symmetry.
● Technique:
- Deep linear threads or micro-bolus placement in pre-jowl sulcus and marionette groove.
- Superficial refinement to smooth shadow line.
- Cannula used in most cases for improved control.
● Anaesthesia: Topical or local if required.
● Procedure time: 30 – 45 minutes including consultation.
● Follow-up : 2 weeks to assess integration and symmetry.
TIMELINE OF RESULTS
● Immediately: Downturned corners soften.
● 1 – 2 weeks : Filler integrated, natural contour restored.
● 6 – 12 months : Result maintained; review advised annually.
● 1 – 2 weeks : Filler integrated, natural contour restored.
● 6 – 12 months : Result maintained; review advised annually.
AFTERCARE
● Avoid pressure or massage for 48 hours.
● No gym, alcohol, or high heat for 24 hours.
● Avoid dental work or facial treatments for 2 weeks.
● SPF 50 daily and gentle skincare.
● No gym, alcohol, or high heat for 24 hours.
● Avoid dental work or facial treatments for 2 weeks.
● SPF 50 daily and gentle skincare.
COMPLIANCE STATEMENT
● Hyaluronic acid fillers used at Dr Hans Clinics are CE-marked Class III medical devices.
● Fillers used at Dr Hans Clinics – including Kysense®, Juvederm®, Belotero®, and Revanesse® – are CE-marked Class III medical devices administered by medical professionals only.
● Treatments are provided after medical consultation and prescriber assessment.
● No product is advertised as superior; selection depends on skin thickness and anatomy.
● Fillers used at Dr Hans Clinics – including Kysense®, Juvederm®, Belotero®, and Revanesse® – are CE-marked Class III medical devices administered by medical professionals only.
● Treatments are provided after medical consultation and prescriber assessment.
● No product is advertised as superior; selection depends on skin thickness and anatomy.
EVIDENCE REFERENCES
● Pavicic T et al. Lower-eyelid rejuvenation with HA fillers: safety and outcomes. Aesthetic Surg J 2021.
● Pavicic T et al. Assessment of HA filler performance in marionette and perioral correction. J Clin Aesthet Dermatol 2021.
● Pavicic T et al. Assessment of HA filler performance in marionette and perioral correction. J Clin Aesthet Dermatol 2021.
Pricing
Each syringe is single-use, sterile, and disposed of after treatment.